THE EFFECTIVENESS CRITERIA FOR THE TREATMENT OF TUBERCULOSIS PATIENTS:

1.Disappearance of clinical and laboratory signs of tuberculous inflammation.

2.Stable cessation of bacilliform excretion confirmed by microscopic and culture studies.

3.Regression of residual radiological manifestations of tuberculosis on the background of adequate therapy during the last 2 months.

•Clinical cure is the disappearance of all signs of active tuberculosis process as a result of the main course of comprehensive treatment.

•Bacteriuria - patients with active tuberculosis who have TB in excreted biological fluids and/or pathomorphological material.

•Abacillosis - disappearance of MBT from externally excreted biological fluids and pathological excretions from patient's organs, confirmed by 2 consecutive (bacterioscopy and culture) examinations with intervals of 2 - 3 months after the first negative test.

Residual post-tuberculosis changes - dense calcified foci and foci of varying size, fibrotic scarring and cirrhotic changes (including residual sanitised cavities), pleural effusions, postoperative changes in lungs, pleura and other organs and tissues, functional abnormalities, determined after clinical cure has been established.

Small residual changes - single (up to 3 cm), small (up to 1 cm), dense and calcified foci, limited fibrosis (within 2 segments). Large residual changes all other residual changes.

Destructive tuberculosis is an active form of tuberculosis process with the presence of tissue decay as determined by radiotherapy.

Progression is the appearance of new signs of active TB process after a period of improvement or intensification of existing signs of the disease during follow-up in DGA I and II until a diagnosis of clinical cure is made.

Relapse is the appearance of signs of active tuberculosis in persons who have previously had the disease and have been cured by follow-up in DGA III or by deregistration due to convalescence.

DIAGNOSTIC FORMULATION: name the

disease (tuberculosis), indicate the clinical form, localisation, phase, presence of bacterial discharge.

When a patient is transferred to a control group (DGN III), the diagnosis is formed as follows: "Clinical cure of a form of tuberculosis (give the most severe diagnosis during the period of illness) with (large, small) residual post-tuberculosis changes in the form of (specify nature and extent of changes)".

THE COMPONENTS OF A MODERN DIAGNOSIS OF TUBERCULOSIS

1.Nosological diagnosis;

2.History of the disease;

3.Clinical form;

4.Localisation and extent of the process;

5.Complications;

6.Functional disorders;

7.Background diseases;

8.Contagiousness of patients (bacteriuria);

9.The properties of the pathogen, especially drug sensitivity.

TUBERCULOSIS DIAGNOSTIC METHODS

DETECTION OF CHANGES IN ORGANS AND TISSUES CHARACTERISTIC OF TUBERCULOSIS:

•Indirect methods:

–anamnesis and physical examination;

–biochemical examinations;

–functional examinations.

•Direct methods - imaging of structural changes:

•in tissues - morphological diagnosis;

•in organs - radiological diagnosis.

TUBERCULOSIS DIAGNOSTIC METHODS

DETECTION OF THE TUBERCULOSIS PATHOGEN: Indirect methods:

•tuberculinodiagnosis;

•anti-tuberculosis antibody testing;

•examination of the release of γ-interferon under the influence of specific MBT agents.

Direct methods:

•bacterioscopic diagnosis;

•bacteriological diagnosis;

•MBT antigen detection;

•molecular biological methods.

1. PRINCIPLES OF CLINICAL EXAMINATION

ANAMNESIS:

Contact with tuberculosis patients, previous tuberculosis, residual tuberculosis changes in the lungs, mental and physical trauma, hyperinsulation, use of medical jars, treatment with steroid hormones and immunosuppressants, malnutrition, comorbidities (diabetes, peptic ulcer disease, pneumoconiosis, alcoholism, chronic respiratory diseases).

1. PRINCIPLES OF CLINICAL EXAMINATION

THE TYPICAL COMPLAINTS:

1.WEAKNESS.

2.INCREASED FATIGUE.

3.LOSS OF APPETITE.

4.LITTLE.

5.IRRITABILITY.

6.DECREASED CAPACITY FOR WORK.

7.INCREASED BODY TEMPERATURE (FEVER).

8.INCREASED SWEATING (INCLUDING NIGHT SWEATS).

9. COUGHING.

10.PRESENCE OF SPUTUM.

11.CHEST PAIN.

12.HEMOPTYSIS (PULMONARY HEMORRHAGE).